tbuckley/cabot-search huggingface dataset:
Abstract P672: Association of Intima-Media Thickness Measured at the Common-Carotid Artery With Incident Carotid Plaque
Authors: Lena Tschiderer, Peter Willeit
Journal: Circulation (2023)

Background: The association between common-carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterised fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods: We undertook an individual-participant-data meta-analysis of prospective studies from the Proof-ATHERO consortium that recorded baseline CCA-IMT and incident carotid plaque. We excluded participants with a history of cardiovascular disease or pre-existing carotid plaque at baseline. Incident carotid plaque was defined as the development of first-ever plaque during follow-up in any segment of the carotid artery. We calculated study-specific odds ratios for incident carotid plaque using logistic regression and then combined study-specific estimates using random-effects meta-analysis. Results: We analysed data from 21,494 individuals in 20 studies. Mean baseline age was 56 years (SD 9), 55% were female, and mean baseline CCA-IMT was 0.71 mm (SD 0.17). Over a median follow-up of 5.9 years (5 th -95 th percentile 1.9-19.0), 8,278 individuals developed first-ever carotid plaque. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. In an analysis adjusted for age, sex, and trial arm, the odds ratio for incident carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% confidence interval 1.31-1.50; I 2 =63.9%). In an analysis further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low-density and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication, the corresponding odds ratio was 1.34 (1.24-1.45; I 2 =59.4%; 14 studies; 16,297 participants; 6,381 incident plaques). We observed no significant effect modification across clinically relevant subgroups including age, sex, lipid-lowering medication, low-density lipoprotein cholesterol, development of cardiovascular disease during follow-up, type of study, and type of CCA-IMT measure. In a sensitivity analysis restricted to studies defining carotid plaque as focal thickening, the odds ratio was similar as in the primary analysis (1.38; 1.29-1.47; I 2 =57.1%; 14 studies; 17,352 participants; 6,991 incident plaques). Conclusions: In this large-scale meta-analysis based on participant-level data, CCA-IMT was associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors. The association was robust across sensitivity analyses and similarly strong for women and men and for individuals at different ages.
Abstract P310: Dietary Pattern Associated With Future Better Gait Speed in a Japanese General Population: Tanushimaru Cohort Study
Authors: Nagisa Morikawa, Mika Enomoto, Ako Fukami, Hiromi Sato, Hisashi Adachi, Yoshihiro Fukumoto
Journal: Circulation (2023)

Introduction: Sarcopenia is a core contributor to falls, fractures and disability. Previous cohort studies showed that healthy dietary pattern like plant-focused diets had beneficial effects on cognitive and physical health. However, few longitudinal studies have investigated the association between dietary patterns and future gait speed, which is strongly related to sarcopenia. Therefore, we aimed to evaluate the relationship between dietary patterns and gait speed in a 9-year follow-up. Methods: We recruited 1943 men and women aged 40 to 95 years in the prospective Tanushimaru cohort study in Japan in 2009. Their dietary intake was assessed using a brief self-administered diet history questionnaire (BDHQ). Principal component analysis (PCA) identified the main dietary patterns. In 976 participants re-examined in 2018, walk time for 5m was examined and &lt;1m/sec of gait speed was defined as slow gait speed. Multivariable logistic regression analyses were performed to examine the association of the main dietary patterns with slow gait speed. Covariates included traditional cardiovascular risk factor (hypertension, dyslipidemia and diabetes), history of cardiovascular diseases, physical activity and cognitive function at baseline. Results: The prevalence of slow gait speed in 2018 was 46.9%. The PCA revealed three major dietary patterns: vegetable pattern (vegetables, potatoes, mushrooms and seaweeds); rice pattern (rice, bread and miso soup); and alcohol pattern (alcoholic beverages, cakes and snacks). The higher vegetable pattern score was significantly associated with slower gait speed (p=0.002), while other patterns were not. Estimated risk for slow gait speed in the fully-adjusted model was 39.1% in the highest versus 55.8% in the lowest tertile of vegetable dietary pattern scores (p=0.001). Conclusions: The vegetable pattern was significantly associated with a lower risk for slow gait speed in a 9-year follow-up.
Abstract P363: Knowledge of COVID-19-Related Risk Factors and Conditions Among Asian American, Native Hawaiian, and Pacific Islander Adults, February-April 2022
Authors: Lan N Doan, Laura Wyatt, Jin Park, Simona C Kwon, Stella S Yi
Journal: Circulation (2023)

Introduction: Communities of color, including Asian Americans (AAs), Native Hawaiians and Pacific Islanders (NH/PIs), experienced higher rates of COVID-19 infection, hospitalization and death compared to white populations during the early pandemic. Further, there are known disparities in cardiovascular disease (CVD) risk factors among AA and NH/PI groups that existed pre-pandemic (e.g., greater prevalence of diabetes among Filipino and Asian Indian compared to white adults). These outsized risks are combined with the increased experience of anti-Asian racism in this period along with historical distrust of health institutions, and legacies of structural racism that have made communities of color vulnerable to the pandemic. The purpose of this study was to understand knowledge of COVID-19-related conditions among AA and NH/PI ethnic groups, in order to anticipate and mitigate further COVID-19 and CVD disparities. Hypothesis: We hypothesize that knowledge of post-COVID-19 conditions and variants would vary by disaggregated AA and NH/PI ethnic group. Methods: The National COVID-19 Rapid Needs Assessment was conducted among AA and NH/PI adults from February to April 2022 with the help of ten community partners (n = 1,358; 1,197 AAs and 153 NH/PIs). The survey was primarily administered online in English and 11 Asian languages. We examined the following COVID-19 knowledge outcomes: vaccine breakthrough infections, COVID-19 variants, and long COVID. Responses included: ‘I know a lot about it,’ ‘I know a moderate amount about it,’ ‘I have heard of it, but don’t know much about it,’ and ‘I haven’t heard of it.’ Outcomes were disaggregated by seven AA (Chinese, Taiwanese, Filipino, Japanese, Korean, Vietnamese, South Asian) and two NH/PI (Polynesian, Micronesian) subgroups. Additional analyses will examine differences in knowledge based on misinformation and disinformation in the absence of timely, language concordant COVID-19 information. Results: Among AAs overall, 14.0% had not heard of vaccine breakthrough infections; 7.4% had not heard of COVID-19 variants; and 11.7% had not heard of long COVID. South Asian adults reported the lowest knowledge of COVID-19, while Filipinos reported the highest knowledge. Among NH/PI adults, 27.2% had not heard of vaccine breakthrough infections; 6.6% had not heard of COVID-19 variants; and 28.4% had not heard of long COVID. Both NH/PI subgroups reported very low knowledge of breakthrough infections and long COVID. Conclusion: Findings indicate COVID-19-related knowledge disparities across AA and NH/PI ethnic subgroups which may be more pronounced among South Asian and NH/PI communities. The COVID-19 pandemic will exacerbate known CVD health disparities if the pandemic mitigation strategies (e.g., disaggregated racial/ethnic data collection) are not inclusive of communities of color, immigrants and limited English fluent populations.
Abstract P337: Determinants and Influence of Breast Arterial Calcifications on Risk of Cardiovascular Disease
Authors: Shadi Azam, Rulla Tamimi, Michele Drotman, Kemi Babagbemi, Allison Levy, Jessica Pena
Journal: Circulation (2023)

Background: Breast arterial calcifications (BAC) are incidentally observed on screening mammography. BAC has been shown to be associated with the presence of coronary artery calcification (CAC) and increased risk of coronary artery disease (CAD). Given that population-based mammography is currently recommended to women, the evaluation of BAC may be important in identifying high-risk women without additional cost or radiation exposure. Aims: We sought to identify reproductive and cardiovascular risk factors associated with the presence of detectable BAC and CAC in women participated to mammography screening. Also, we aimed to determine the association between BAC and presence of CAC. Further, we investigated presence of BAC, CAC and estimated 10-year risk of atherosclerotic cardiovascular disease (ASCVD). Methods: In this cross-sectional study, reproductive history and CVD risk factors were obtained in 215 women ≥ 18 years of age that underwent mammography and cardiac computed tomographic angiography (CCTA) within 2 years of each other between January 2007 and September 2017 at Weill Cornell Medicine/ New York Presbyterian hospital (WCM/NYP). BAC was recorded in two ways: a binary scale (presence/absence) and a semi-quantitative scale (mild, moderate, severe). CAC was calculated using the Agatston method and was recorded as a binary variable (presence/absence). Information regarding reproductive history and CVD risk factors, medical history, and relevant demographics were obtained by chart review. Odds ratios (ORs) and 95% confidence intervals (CIs), with adjustment for age at study entry as a potential confounder, were estimated. The 10-year risk of atherosclerotic cardiovascular disease (ASCVD) was calculated using the Pooled Cohort Risk Equations. Results: The odds of presence of BAC increased with increasing age . Women age ≥60 had a near 6-fold higher odds of BAC (OR = 5.77; 95% CI = 2.45 to 16.00) compared with women &lt;60 years old. Other factors associated with presence of BAC after controlling for age were diastolic blood pressure ≥80 ( P = 0.0008), systolic blood pressure ≥140 ( P = 0.0009), number of children (P = 0.01). Younger age at first birth (≤28 years) was associated with 3-fold higher odds of BAC compared with women with age at first birth &gt;28 years. Except for age at study entry, the only factor associated with presence of CAC was hyperlipidemia ( P = 0.002). We found no association between presence of BAC with CAC. We observed women with presence of both BAC and CAC had the highest estimated 10-year risk of ASCVD: 18.54%, followed by presence of BAC but absence of CAC 11.65%, absence of BAC and presence of CAC 6.01%, and women with no BAC and no CAC presence had a mean 10-year risk of ASCVD of 5.25%. Conclusions: These findings support the value of BAC in identifying women at potentially increased risk of future cardiovascular disease without additional cost and radiation exposure.
Abstract P315: Depressive Symptoms and Cardiovascular Health Among Young Adults in Puerto Rico
Authors: Milagros C Rosal, Andrea Lopez-Cepero, Israel Almodovar, Catarina Kiefe, Katherine L Tucker, Sharina Person, Jose Rodriguez-Orengo, Cynthia Perez
Journal: Circulation (2023)

Background: Depressive symptoms are associated with cardiovascular disease (CVD) incidence, morbidity and mortality. Less is known about the association between depressive symptoms and overall cardiovascular health (CVH) of young adults, an age group that commonly experiences depressive symptoms. We examined the association between depressive symptoms and a metric of overall CVH among young Puerto Ricans, a high risk but understudied population. Measures: We used data from PR-OUTLOOK, a study of CVH among individuals aged 18-29 residing in Puerto Rico, obtained between September 2020 and September 2022. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). CVH was assessed using the AHA Life’s Essential 8 metric, which includes modifiable behavioral (nicotine exposure, diet, physical activity, sleep health) and biological (body mass index- BMI, blood lipids, blood pressure, and blood glucose) components. For this analysis, this metric was modified to exclude diet. Higher scores (range 0-100), overall and for each component, indicate better CVH. Covariates included age, sex, marital status, and childhood material deprivation. Multivariable linear regression models were used to assess the relationships of CES-D-10 score with overall CVH score and its individual components. An interaction term for sex and CES-D-10 was added to the models to examine potential differences by sex. Results: The sample (n=964; mean age: 22.6 ±3.1) was largely female (64%) and single (89%), and a third (33%) reported having experienced material deprivation in childhood. Over half (58.6%) reported depressive symptoms above the cut-off for likely clinical depression (CES-D-10 &gt;10). The overall mean CVH score was 80.2±12.8, with almost half of the sample (42.8%) having a score &lt; 80. Mean scores for the CVH components were lowest for physical activity (57.2±43.2) and BMI (71.4±33.9). In adjusted models, significant inverse associations were observed between CES-D-10 with overall CVH (-4.21, 95%CI: -5.84,-2.58) and several CVH components: nicotine exposure (-4.28; 95%CI: -8.28,-0.28), physical activity (-9.32; 95%CI: -14.87,-3.78), BMI (-6.54; 95%CI: -10.94,-2.15), and blood pressure (-3.02; 95%CI: -5.81,-0.23). No significant interaction was observed between CES-D-10 and sex. Conclusion: Depressive symptoms were inversely associated with CVH and four of the seven assessed CVH components. Longitudinal analyses should elucidate the potential contribution of depressive symptoms to reduction in CVH in young adults. Understanding factors associated with CVH among young Puerto Ricans may help elucidate CVD prevention targets for this vulnerable population.
Abstract 66: Clonal Hematopoiesis of Indeterminate Potential and Incident Type 2 Diabetes Risk
Authors: Deirdre K Tobias, Alisa Manning, Jennifer Wessel, Sridharan Raghavan, Kenneth Westerman, Alexander G Bick, Daniel Dicorpo, Eric A Whitsel, Jason M Collins, Josee Dupuis, Mark O Goodarzi, Barbara V Howard, Leslie Lange, Simin Liu, Laura M Raffield, Alexander P Reiner, Stephen S Rich, Lesley Tinker, James Wilson, April P Carson, Ramachandran Vasan, Charles Kooperberg, Jerome I Rotter, James Meigs, Joann E Manson
Journal: Circulation (2023)

Introduction: Clonal hematopoiesis of indeterminate potential (CHIP) is an aging-related accumulation of somatic mutations in hematopoietic stem cells, leading to clonal expansion. CHIP presence has been implicated in elevated risks for coronary heart disease (CHD) and death, but its association with incident type 2 diabetes (T2D) is unknown. Hypothesis: We hypothesized that CHIP is associated with elevated risk of incident T2D. Methods: CHIP was derived from whole genome sequencing of blood DNA in NHLBI Trans-omics for Precision Medicine (TOPMed) cohorts. We analyzed 17,637 participants without prior T2D, cardiovascular disease, or cancer at blood draw, with prospective follow-up for incident T2D. We evaluated baseline prevalence of CHIP vs. no CHIP with incident T2D risk using Cox regression. We also investigated CHIP variants previously related to CHD: DNMT3A , TET2 , ASXL1 , JAK2 , and TP53 . We estimated multivariable-adjusted hazard ratios and 95% confidence intervals (HR [CI]) adjusted for age, sex, body mass index, smoking, alcohol, and education. We combined cohort estimates via fixed effects meta-analysis. Results: On average, participants were age 63.4 years (SD=11.5) and 76% female. Prevalence of CHIP was 6.0% (1,055) at baseline. There were 2,467 incident T2D cases over mean=9.8 years follow-up. Compared to those without a mutation, having CHIP was associated with a 23% higher T2D risk, both overall (combined HR=1.23; 95% CI=1.04, 1.45), and among those with CHD-related CHIP mutations (87% of total CHIP): HR=1.23 (1.03, 1.46). Although those with CHIP mutations of TET2 (HR=1.48; 1.05, 2.08) and ASXL1 (HR=1.76; 1.03, 2.99) had larger elevations in T2D risk, and DNMT3A was suggestive of increased T2D risk (HR=1.15; 0.93, 1.43), statistical power was limited for JAK2 and TP53 mutation analyses. Conclusions: CHIP was associated with higher incidence of T2D. CHIP mutations located on loci previously implicated in aging and CHD were also related to T2D, suggesting shared pathology of atherosclerosis and T2D.
Abstract P673: Intima-Media Thickness at the Near or Far Wall of the Common-Carotid-Artery in Cardiovascular Risk Assessment
Authors: Lisa Seekircher, Peter Willeit
Journal: Circulation (2023)

Background: Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common-carotid-artery (CCA). Objectives: To reliably quantify associations of near vs. far wall CCA-IMT with cardiovascular risk and their added predictive values. Methods: We analyzed participant-level data of 16 prospective studies from the Proof-ATHERO consortium. We pooled study-specific hazard ratios for cardiovascular disease (CVD, defined as coronary heart disease or stroke) using random-effects meta-analysis. Results: Individual records were available for 41,941 participants (mean age 61 years [SD=11]; 53% female; 16% with history of CVD; 10,423 CVD events, median follow-up 9.3 years). Mean baseline values of near and far wall CCA-IMT were 0.83 (SD=0.28) and 0.82 (SD=0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: -0.40 to 0.43) and were moderately correlated (r=0.44; 95% CI: 0.39-0.49). Near and far wall CCA-IMT were both approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14-1.22; I 2 =30.7%) and 1.20 (1.18-1.23; I 2 =5.3%) when adjusted for age, sex, and history of CVD, and 1.09 (1.07-1.12; I 2 =8.4%) and 1.14 (1.12-1.16; I 2 =1.3%) in a multivariable adjusted model (all P&lt;0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only (+0.0046 vs. +0.0023 for near [P&lt;0.001] or +0.0037 for far wall [P=0.006]). Conclusions: The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls.
Abstract MP63: Higher Alternative Healthy Eating Index Scores Including Greater EPA and DHA Consumption Are Associated With Attenuated Platelet Function in the Framingham Heart Study
Authors: Robin Pashek, Bongani Nkambule, Melissa Chan, Florian Thibord, Amber Lachapelle, Jason Cuhna, Ming-Huei Chen, Paul Jacques, Jiantao Ma, Andrew Johnson
Journal: Circulation (2023)

Introduction: Dietary modification that reflects healthy eating is a notable strategy for CVD prevention on a population level. The cardioprotective role diet plays in hemostasis and thrombosis, particularly in respect to platelet function remains unclear. Hypothesis: Healthier Alternative Healthy Eating Index (AHEI) scores associate with attenuated platelet reactivity in a large-scale population cohort. Methods: Cross-sectional data was obtained from Framingham Heart Study participants (N=3,429). AHEI scores were derived from self-reported Harvard semi-quantitative food frequency questionnaires. Ranging from 0 to 110, higher AHEI scores reflect healthier overall diet quality. Five bioassays measured platelet reactivity traits across several agonists in whole blood and platelet-rich plasma samples. Linear mixed effects models adjusted for age, sex, aspirin use, family relatedness, daily energy intake, and BMI evaluated associations between platelet reactivity and AHEI scores and components. Results: Higher AHEI scores associated with attenuated platelet reactivity among 16 different traits (P&lt;0.01), with notable decreased platelet aggregation to collagen, TRAP6 (PAR1 agonist), ADP, and ristocetin. Of the 11 AHEI components, higher EPA &amp; DHA intake was most strongly associated to decreased platelet function with the greatest number of significant associations to platelet traits (18 traits, P&lt;0.01) and moderate negative effect sizes (Figure 1). Conclusions: We report that higher AHEI scores associate with decreased platelet reactivity. Effects appear strongest for EPA &amp; DHA intake consistent with several small randomized controlled trials. However, we found that a holistic AHEI score reflects a better interpretation of diet as a modulator of platelet function compared to individual components. Our results conclude that the impact of a healthier diet in preventing thrombosis may be partially mediated through a decline in platelet reactivity through multiple independent activation pathways.
Abstract MP10: Healthy Diet Perception vs Actual Diet Quality for Cardiovascular Health: Prevalence and Predictors of Perceiving a Poor Diet as Healthy Among Adults
Authors: Eileen Lee, Aayush Visaria, Shauna Downs, Nurgul Fitzgerald, Nathaniel Kuhrt, Soko Setoguchi
Journal: Circulation (2023)

Objective: A healthy diet is key to preventing and managing CVD. Despite clear AHA guidelines, eating healthy can be difficult due to misinformation. We investigated perceived vs. actual diet quality and what contributes to perceiving a poor diet ‘healthy’. Methods: We identified adults aged &gt; 19 in 2005-2018 National Health and Nutrition Examination Survey. Healthy perceived diet was defined as answering “excellent” or “very good” to “how healthy is the diet?”. We assessed actual diet quality by calculating AHA Healthy Diet Score based on a 24-hour dietary recall and scaled the raw score to 0-100%; ‘poor diet’ was defined as AHA score &lt; 40%. We first estimated prevalence of poor actual diet and perceived healthy diet. Among those with poor diet (AHA score &lt; 40%), we fit modified-Poisson regression models to identify factors associated with perceiving a poor diet as ‘healthy’ and reported risk ratios with 95% confidence limits. Results: Among 31,621 adults (50% female, mean age 50, 43% non-Hispanic White, mean BMI 29), prevalence of ‘healthy’ perceived diet and actual ‘poor diet’ was 29% and 47%, respectively. Among adults with a ‘poor diet’ (n=14,951), 23% perceived their diet as ‘healthy’ and many sociodemographic and lifestyle factors and comorbidities were significantly associated with perceiving a poor diet as healthy in univariate analyses (Table). In multivariable analysis, increased age, male sex, White race (compared to Black and Hispanic race), MI history, smaller waist circumference, higher physical activity, and alcohol use were independently associated with perceiving their poor diet as ‘healthy’ (RR ranged from 0.77-1.48, Table). Conclusion: Nearly half of US adults had a poor diet based on dietary targets from AHA 2020 Strategic Impact Goals for CV health, yet nearly a quarter of them perceived their diet as ‘healthy’. Targeting high risk adults with focused educational interventions to calibrate their perception of a healthy diet can be effective in modifying their eating behavior and promoting CV health.